Catheter ablation for papillary muscle arrhythmias: A systematic review.


Journal

Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944

Informations de publication

Date de publication:
04 2022
Historique:
revised: 07 11 2021
received: 22 09 2021
accepted: 30 01 2022
pubmed: 12 2 2022
medline: 8 4 2022
entrez: 11 2 2022
Statut: ppublish

Résumé

Catheter ablation of papillary muscle ventricular arrhythmias (PM-VAs) has been associated with unsatisfactory results. Features that may affect acute and long-term procedural outcomes are not well established. To systematically review the available data in the literature assessing efficacy and safety of PM-VAs catheter ablation. An online search of PubMed, Cochrane Registry, Web of Science, Scopus and EMBASE libraries (from inception to March 1, 2021) was performed, in addition to manual screening. Twenty-one observational noncontrolled case-series were considered eligible for the systematic review, including 536 patients. Postero-medial PM harbored 60.8% of PM-VAs, while antero-lateral PM and right ventricular PMs 34.9% and 4.3% of cases, respectively. The mean acute success rate of the index ablation procedure was 88.1% (95% CI 82.8% to 91.9%, p < .001, I Catheter ablation is an effective and safe strategy for PM-VAs, with an acute success rate of 88.1%, a long-term success rate of 69.2%, with a relatively low procedural complication rate. The use of ICE, irrigated catheters and catheters with CFS capability was associated with higher rates of arrhythmia-freedom at long-term follow-up.

Sections du résumé

BACKGROUND
Catheter ablation of papillary muscle ventricular arrhythmias (PM-VAs) has been associated with unsatisfactory results. Features that may affect acute and long-term procedural outcomes are not well established.
OBJECTIVE
To systematically review the available data in the literature assessing efficacy and safety of PM-VAs catheter ablation.
METHODS
An online search of PubMed, Cochrane Registry, Web of Science, Scopus and EMBASE libraries (from inception to March 1, 2021) was performed, in addition to manual screening. Twenty-one observational noncontrolled case-series were considered eligible for the systematic review, including 536 patients.
RESULTS
Postero-medial PM harbored 60.8% of PM-VAs, while antero-lateral PM and right ventricular PMs 34.9% and 4.3% of cases, respectively. The mean acute success rate of the index ablation procedure was 88.1% (95% CI 82.8% to 91.9%, p < .001, I
CONCLUSIONS
Catheter ablation is an effective and safe strategy for PM-VAs, with an acute success rate of 88.1%, a long-term success rate of 69.2%, with a relatively low procedural complication rate. The use of ICE, irrigated catheters and catheters with CFS capability was associated with higher rates of arrhythmia-freedom at long-term follow-up.

Identifiants

pubmed: 35147225
doi: 10.1111/pace.14462
pmc: PMC9302647
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

519-531

Informations de copyright

© 2022 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.

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Auteurs

Marco Valerio Mariani (MV)

Department of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences "Sapienza", University of Rome, Rome, Italy.

Agostino Piro (A)

Department of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences "Sapienza", University of Rome, Rome, Italy.

Michele Magnocavallo (M)

Department of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences "Sapienza", University of Rome, Rome, Italy.

Cristina Chimenti (C)

Department of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences "Sapienza", University of Rome, Rome, Italy.

Domenico Della Rocca (D)

St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, Texas, USA.

Pasquale Santangeli (P)

Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Andrea Natale (A)

St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, Texas, USA.

Francesco Fedele (F)

Department of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences "Sapienza", University of Rome, Rome, Italy.

Carlo Lavalle (C)

Department of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences "Sapienza", University of Rome, Rome, Italy.

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Classifications MeSH